What is it about?

According to the Institute of Medicine in the USA. The Clinical Practice Guidelines (CPG) are documents based on a systematic review of the evidence and on the evaluation of the risks and benefits of the different alternatives, to optimize patient health care. The CPG could be a handy tool for clinicians when they care for their patients. Scientific research, when it is of good quality produces new evidence that can benefit the patient and health systems. The problem that motivated us to carry out this work was the uncertainty that arose on us because there was some evidence of the effect of the use of CPGs in improving the quality of health care. We decided to do a Systematic Review, that is, a review of published and unpublished studies, in any language and from there a synthesis according to the Cochrane proposed methodology. (www-cochrane.org). The type of integration possible in this case was more narrative than analytical because there was a lot of variability in the studies. The initial search was done and given the volume of studies found we decided to do three reviews. The review is the first of a series of three — the current subject of CPG effects for cardiovascular diseases.

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Why is it important?

In today's world, there is significant variability in clinical decision making at the time of patient care. Also, the therapeutic, diagnostic and prevention arsenal grows a lot. The original scientific publications exceed the possibility of time and skill of professionals to analyze what is most convenient for the treatment of patients safely and effectively. CPGs, as a summary of scientific evidence, is a tool to be used in everyday practice. The CPGs have been designed with the most rigorous methods to guarantee the best use of the evidence of clinical research. In the understanding that with this tool, the quality of health services would be improved. However, the findings of this review show that this improvement is milder than expected. And it is smaller according to the results of the health of the patient. It seems that this is due to the little use made by the CPG clinicians due to several possible causes beyond the clinician's desire. We do not believe that we; should abandon the development of CPG. Instead, all should strengthen the implementation process to help the change that the use of CPG means.


As co-author of this publication, I am happy as is everyone in the group that is working on this project to explore the effect of the CPG and what should be done to achieve greater use and positive outcome. We have prepared this publication to present these results on measuring the impact of the Clinical Practice Guidelines on the improvement of health systems in the three domains suggested by the renowned researcher in health care quality analysis Avedis Donabedian (1919- 2000). We will continue with the preparation of the three publications to evaluate the impact of the CPG on other issues such as breast cancer and diabetes mellitus

Mario Tristan
International Health Central American Institute Foundation

That the impact assessment of CPGs is an increasingly common practice.

Anggie Ramirez
IHCAI Institute

Read the Original

This page is a summary of: Effects of evidence-based clinical practice guidelines in cardiovascular health care quality improvements: A systematic review, F1000Research, September 2019, Faculty of 1000, Ltd., DOI: 10.12688/f1000research.18865.2.
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